Provider Demographics
NPI:1003856188
Name:UNGER, JEFFREY ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ROBERT
Last Name:UNGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:13123 CARRIAGE TRAIL CT
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91739-8939
Mailing Address - Country:US
Mailing Address - Phone:951-255-5575
Mailing Address - Fax:909-590-8695
Practice Address - Street 1:14726 RAMONA AVE
Practice Address - Street 2:#110
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-5730
Practice Address - Country:US
Practice Address - Phone:909-590-8409
Practice Address - Fax:909-590-8695
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2012-06-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG45569207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A50094Medicare UPIN
CA00G455690Medicare ID - Type Unspecified